癫痫 

癫痫
同义词腦癇、羊癇、羊癲瘋、羊角風、豬腳瘋、發羊吊、鬼上身
An electroencephalogram of a person with childhood absence epilepsy showing a seizure. The waves are black on a white background.
兒童失神性癲癇英语childhood absence epilepsy患者的腦電波釋放出的3赫茲棘徐波英语Spike-and-wave
症状顯著地晃動(Periods of vigorous shaking)、其他人幾乎難以辨識其發音內容(nearly undetectable spells)[1]
病程長期[1]
类型腦病變疾病
肇因腦部受傷英语brain injury中風脑肿瘤、腦部受到感染、先天性障碍[1][2][3]
診斷方法腦電圖、排除其他可能原因[4]
相似疾病或共病昏厥酒精戒斷症候群電解質不平衡[4]
治療藥物、外科学神經元刺激英语neurostimulation、飲食調整[5][6]
预后70% 可以控制[7]
盛行率3,900萬 / 0.5% (2015)[8]
死亡數125,000 (2015)[9]
分类和外部资源
醫學專科神經內科
ICD-9-CM345.9、​345.91、​345、​345.90、​345.8、​345.80
DiseasesDB4366
MedlinePlus000694
eMedicine1184846
Orphanet101998

癲癇[10][11][12][13](英語:Epilepsy)又稱腦癇症[14],是一種神經性疾患英语Neurological disorders,特徵為反覆地癲癇發作[15][16],即為重複發作或長或短的嚴重抽搐症狀[1],可能會造成物理性傷害,甚至骨折[1]。患者傾向在無誘發原因下持續重複地發作[15];因中毒等特定原因引發的單次性癲癇發作(英語:Isolated seizures)不歸類為癲癇[17]。癲癇的治療方式在各地各有不同,患者常因其病況而遭到各種程度的汙名化[1]

大多數癲癇病例的肇因尚未釐清[1],在少數病例中肇因於腦損傷中風腦腫瘤、腦部感染或先天性障礙,經致脑痫作用英语Epileptogenesis而致病[1][2][3];而一小部分的癲癇病例與已知的基因突變直接相關[18][19]。癲癇發作是大腦皮質中過度且異常的神經元活動所產生的結果[17]。癲癇的診斷必須先排除其他可能造成類似症狀的情況,例如昏厥;以及判斷是否有其他造成發作的原因,例如酒精戒斷症候群電解質方面的問題。這部分可以借助神經成像血液檢查[18]。異常的腦電圖檢查結果可以佐證癲癇的診斷,但正常的腦電圖檢查結果則無法排除癲癇的可能性[18]。由其他原因造成的癲癇可能是可以預防的[1]

70%的發作可藉由藥物控制[7],平價的抗發作藥物通常也不難取得[1]。而30%無法以藥物控制的發作則可以考慮外科學的方式,或是神經刺激英语Neurostimulation,和飲食調整[5][6][已过时]。並不是所有的癲癇都會持續終生,許多人的狀況可以改善到不再需要治療的程度[1]

截至2015年 (2015-Missing required parameter 1=month!),有3,900萬人罹患癲癇[8],將近80%是在发展中國家[1]。2015年全世界有12萬5千人因為癲癇而死亡,較1990年的11萬2千人要多一些[9][20]。癲癇在年長者身上較容易出現[21][22]。在已開發國家,新增的病例最常出現在嬰兒及年長者[23]。在開發中國家,因為根本病因的差異,新增病例會以年齡較大的兒童及青年為主[24]。有5%至10%的人會在80歲以前出現無故的癲癇發作[25],這些人中再次癲癇發作的比例佔40%至50%[26]。許多地區的癲癇患者的駕駛資格會受限制,或是被要求必須一段時間沒有癲癇發作才能夠駕駛[27]

癲癇的英語「epilepsy」是源自古希臘語的「ἐπιλαμβάνειν」,為「侵襲、佔有、或折磨」之意[28]

  1. ^ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Epilepsy Fact sheet. WHO. February 2016 [4 March 2016]. (原始内容存档于11 March 2016). 
  2. ^ 2.0 2.1 引证错误:没有为名为Ham2010的参考文献提供内容
  3. ^ 3.0 3.1 Goldberg, EM; Coulter, DA. Mechanisms of epileptogenesis: a convergence on neural circuit dysfunction.. Nature Reviews Neuroscience. May 2013, 14 (5): 337–49. PMC 3982383可免费查阅. PMID 23595016. doi:10.1038/nrn3482. 
  4. ^ 4.0 4.1 Longo, Dan L. 369 Seizures and Epilepsy. Harrison's principles of internal medicine 18th. McGraw-Hill. 2012: 3258. ISBN 978-0-07-174887-2. 
  5. ^ 5.0 5.1 Bergey GK. Neurostimulation in the treatment of epilepsy. Experimental Neurology. June 2013, 244: 87–95. PMID 23583414. doi:10.1016/j.expneurol.2013.04.004. 
  6. ^ 6.0 6.1 Martin, K; Jackson, CF; Levy, RG; Cooper, PN. Ketogenic diet and other dietary treatments for epilepsy.. Cochrane Database of Systematic Reviews. 9 February 2016, 2: CD001903. PMID 26859528. doi:10.1002/14651858.CD001903.pub3. 
  7. ^ 7.0 7.1 Eadie MJ. Shortcomings in the current treatment of epilepsy. Expert Review of Neurotherapeutics. December 2012, 12 (12): 1419–27. PMID 23237349. doi:10.1586/ern.12.129. 
  8. ^ 8.0 8.1 GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.. The Lancet. 8 October 2016, 388 (10053): 1545–1602. PMC 5055577可免费查阅. PMID 27733282. doi:10.1016/S0140-6736(16)31678-6. 
  9. ^ 9.0 9.1 GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.. The Lancet. 8 October 2016, 388 (10053): 1459–1544. PMC 5388903可免费查阅. PMID 27733281. doi:10.1016/s0140-6736(16)31012-1. 
  10. ^ https://www.termonline.cn/word/1276881119152721921/1
  11. ^ 存档副本. [2022-03-12]. (原始内容存档于2021-05-17). 
  12. ^ 癲癇 epilepsy. 國家教育研究院. [2023-05-20] (中文(臺灣)). 
  13. ^ http://www.neuro.org.tw/files/newsletter/083.pdf
  14. ^ 腦癇症. 港怡醫院. [2023-05-20]. (原始内容存档于2023-05-20) (中文(香港)). 
  15. ^ 15.0 15.1 Chang BS, Lowenstein DH. Epilepsy. The New England Journal of Medicine. September 2003, 349 (13): 1257–66. PMID 14507951. doi:10.1056/NEJMra022308. 
  16. ^ Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S. ILAE official report: a practical clinical definition of epilepsy (PDF). Epilepsia. April 2014, 55 (4): 475–82. PMID 24730690. doi:10.1111/epi.12550. (原始内容 (PDF)存档于9 June 2014). 
  17. ^ 17.0 17.1 Fisher R, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, Engel J. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005, 46 (4): 470–2. PMID 15816939. doi:10.1111/j.0013-9580.2005.66104.x. 
  18. ^ 18.0 18.1 18.2 Longo DL. 369 Seizures and Epilepsy. Harrison's principles of internal medicine 18th. McGraw-Hill. 2012: 3258. ISBN 978-0-07-174887-2. 
  19. ^ Pandolfo, M. Genetics of epilepsy.. Seminars in Neurology. Nov 2011, 31 (5): 506–18. PMID 22266888. doi:10.1055/s-0031-1299789. 
  20. ^ GBD 2013 Mortality Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. January 2015, 385 (9963): 117–71 [2020-02-20]. PMC 4340604可免费查阅. PMID 25530442. doi:10.1016/S0140-6736(14)61682-2. (原始内容存档于2021-03-10). 
  21. ^ Brodie MJ, Elder AT, Kwan P. Epilepsy in later life. The Lancet. Neurology. November 2009, 8 (11): 1019–30. PMID 19800848. doi:10.1016/S1474-4422(09)70240-6. 
  22. ^ Holmes TR, Browne GL. Handbook of epilepsy 4th. Philadelphia: Lippincott Williams & Wilkins. 2008: 7 [2020-02-20]. ISBN 978-0-7817-7397-3. (原始内容存档于2021-03-31). 
  23. ^ Wyllie's treatment of epilepsy : principles and practice. 5th. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. 2010. ISBN 978-1-58255-937-7. (原始内容存档于24 June 2016). 
  24. ^ Newton CR, Garcia HH. Epilepsy in poor regions of the world. Lancet. September 2012, 380 (9848): 1193–201. PMID 23021288. doi:10.1016/S0140-6736(12)61381-6. 
  25. ^ Wilden JA, Cohen-Gadol AA. Evaluation of first nonfebrile seizures. American Family Physician. August 2012, 86 (4): 334–40. PMID 22963022. 
  26. ^ Berg AT. Risk of recurrence after a first unprovoked seizure. Epilepsia. 2008,. 49 Suppl 1: 13–8. PMID 18184149. doi:10.1111/j.1528-1167.2008.01444.x. 
  27. ^ L Devlin A, Odell M, L Charlton J, Koppel S. Epilepsy and driving: current status of research. Epilepsy Research. December 2012, 102 (3): 135–52. PMID 22981339. doi:10.1016/j.eplepsyres.2012.08.003. 
  28. ^ Magiorkinis E, Sidiropoulou K, Diamantis A. Hallmarks in the history of epilepsy: epilepsy in antiquity. Epilepsy & Behavior. January 2010, 17 (1): 103–8. PMID 19963440. doi:10.1016/j.yebeh.2009.10.023. 



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